Lecture 15

Abstract

An overview of elementary symptoms occurring during paranoid states allows us to make the following distinctions: First, we found several changes in content of consciousness, namely delusions and delusional judgments, expressed within an unbroken train of conscious activity, in so far as they were in a logical form, preserving attentiveness and memory, and in their moment-by-moment adaptability to any given situation. However, the intactness of these faculties in no way prevents the remaining content of consciousness appearing to have disintegrated, to a degree, into fragments a fact to which we gave the name ‘sejunction’ [Ed], in other words, the detachment of individual components one from another. Such components initially form tight-knit structures, as complete experiences, but their sejunction is shown by the fact that memories that flatly contradict each other can coexist. The sejunction hypothesis then led us to a closer understanding of certain symptoms of activation, first, of manifestations of disturbed conscious activity itself, then of autochthonous ideas and obsessions [1], and then of hallucinations and delusions of relatedness and reference. Explanatory delusions, which took up much of our discussion, could then be likened to normal expressions of conscious activity, in contrast to the aforementioned primary psychotic symptoms. We then came to recognize subsequent corrections of the content of consciousness as conditions essential for the so-called systematization, itself related closely to explanatory delusions. We also found amongst these corrections a process, which we viewed as normal conscious activity reacting against ‘false intruders’ [Ed]; and we also saw psychotic symptoms in various types of memory falsification, seemingly quite aberrant in themselves, yet appearing to stand in regular relationship with existing disturbances of the content of consciousness, such that their occurrence depended on the extent of changed content. Amongst such psychotic symptoms we distinguished at least three different points of origin, all emerging in part as a reaction of intact conscious activity to alterations of content of consciousness. These included explanatory delusions and subsequent corrections, either of which occurred as a direct consequence of sejunction; the latter included contradictory contents of consciousness in many old cases, and additive and subtractive ways in which memory can be falsified. Lastly, there were excitatory processes arising out of the sejunctive processes: these included hallucinations, delusion of relatedness, and retrospective delusion of relatedness, and finally autochthonous ideas.